[Multicentre observational study on peristomal skin disorders. A proposal classification]. / Studio osservazionale multicentrico sulle alterazioni cutanee post-enterostomie (SACS) Classificazione delle alterazioni peristonali.

Disorders regarding peristomal skin have been more and more investigated in order to establish the impact on quality of life of ostomy patients. The aim of this classification is to provide an objective, standardized tool for the assessment of peristomal skin complication specifically designed on the description and localization of the lesion.

Tissue expansion in neurosurgical reconstructive technique: case report.

BACKGROUND: Various reconstructive techniques using hair-bearing scalp to manage unsightly scalp defects have been described. In 1983, Fonseca and in 1984, Horowitz emphasized the use of galeal-pericranial flaps in scalp wounds with exposed bone. In 1986, Matthews and Missoten described early tissue expansion to close a traumatic defect of the scalp, and in 1990 Kiyono placed tissue expander in a pocket adjacent to the defect that was covered with Marlex Mesh. METHODS: The authors present a case of 23-year-old man with a scalp laceration over a depressed fracture of the skull and a dural tear, after a traffic accident. The repair procedures at another hospital failed, resulting in an area of scalp necrosis with a cerebrospinal fluid (CSF) leak. At our observation, the reconstructive technique using hair-bearing scalp with tissue expander was performed to manage unsightly scalp necrosis. Moreover the neurosurgical treatment was necessary to avoid the complications of the CSF leak. CONCLUSIONS: A 9-year review showed more than 40 patients treated by this technique that allows a pericranial flap of every size. When scalp defects are too large, the tissue expander allows good aesthetic results.

Breast reconstruction according to pTNM: our experience.

Reconstruction of the breast after radical mastectomy has become an integral part of the treatment and rehabilitation of the patient with breast cancer. Any variants of radical mastectomy are the mainstay of the treatment of the majority of patients with breast cancer. We prefer modified radical mastectomy according to the Madden-Auchincloss technique, because the breast reconstruction after this procedure is easier from the anatomic point of view. The three major questions raised in regard to breast reconstruction are: what patient is eligible for breast reconstruction; when should the breast reconstruction be performed; how should the goals of breast reconstruction be realised? There are two basic elements in our therapeutic choice in this field: collaboration of the patient, the evaluation of pTNM.